Shock Treatment for Depression: How ECT Shock Therapy Works

Shock therapy, aka ECT, is common in severe cases of depression. Learn how shock treatment works, along with the risks.

"Shock therapy" was so-called, as an electric shock is used to induce a controlled seizure intended as a treatment for chemical imbalances in the brain. Shock therapy is now known as electroconvulsive therapy or ECT.

The brain is still not well understood, nor is the reason for the curative effects ECT (shock) therapy has on some individuals. Shock therapy was overused and misused in the past and since has come to have a mixed reputation (read about history of ECT procedure). Great care is now taken to ensure ECT treatment is warranted, and signed consent must typically be given before its use.

How to Prepare for a Shock Treatment

A full physical is needed before shock therapy. Because general anesthesia will be administered, do not eat or drink 8-12 hours before the shock treatment. This helps to prevent any vomiting during the procedure. Emptying your bladder right before the shock treatment helps to prevent incontinence.

How Shock Therapy is Performed

Shock therapy is performed in a hospital, sometimes in an area specifically set aside for this treatment. An intravenous (IV) is inserted to provide anesthetic medication. Vital signs are taken initially and continuously throughout the shock therapy treatment.

An anesthesiologist administers anesthesia and after you are asleep, places a tube in your throat to help you breath. A paralyzing agent called succinylcholine is then administered to prevent the seizure from spreading to your body. The electrodes are then applied to your head with conducting jelly and a brief shock (less than 2 seconds) is administered.

How Shock Therapy Feels

When you awake from the anesthesia, you may be confused and tired and will probably experience a brief memory loss, but this should pass. This is typical after any general anesthesia administration. Your vital signs will be monitored closely after the shock treatment to ensure proper recovery. You may feel head, muscle or back pain. Such discomfort is quickly relieved by mild medications.

Why Shock Therapy is Performed

It is most common to see shock therapy for depression, in severe cases. Shock therapy is also performed to improve the condition of the following disorders:1

  • Acute mania
  • Catatonia
  • Occasionally, with types of schizophrenia
  • As a last resort for treatment-resistant obsessive-compulsive disorder (OCD), Parkinson's disease, epilepsy, Tourette syndrome.

Shock treatment for depression and other disorders is indicated when the patient needs rapid improvement because the patient is:

  • Suicidal
  • Self-injurious
  • Refusing to eat or drink
  • Cannot or will not take medication as prescribed
  • Present some other danger to themselves
  • Psychotic
  • Pregnant or otherwise can't take standard medications

Some patients need maintenance ECT. Find out why.

Risks Associated with Shock Therapy (ECT)

Advanced medical technology has substantially reduced the complications associated with ECT / shock therapy. Risks of shock therapy include slow heart beat (bradycardia), rapid heartbeat (tachycardia), memory loss and confusion. Persons at high risk include those with recent heart attack, uncontrolled blood pressure, brain tumors and previous spinal injuries.

Read more comprehensive information about: ECT side effects.

Normal Results After Shock Treatment

Shock treatment for depression often produces a dramatic improvement in symptoms, especially in elderly individuals, sometimes during the first week of treatment. While it is estimated 50% of these patients will experience a future return of depression symptoms, the prognosis for each episode of depression is good. Mania also often responds well to shock treatment. The picture is not as bright for schizophrenia, which is more difficult to treat and is characterized by frequent relapses.

A small number of patients are placed on maintenance shock therapy. This means they return to the hospital every 1-2 months, as needed, for an additional treatment. These individuals choose shock therapy because it can keep their illness under control and help them lead a normal and productive life.

article references


next: Maintenance ECT: Why Some People Need Continuation ECT
~ all articles on ect
~ all articles on depression

Last Updated: 18 June 2016
Reviewed by Harry Croft, MD

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